Home Care and In-Home Care: What's Covered, What's Not?

Sharon Roth Maguire，科学硕士，注册护士，是首席临床素质官员BrightStarCare®.是一家提供家庭护理服务的公司。沙龙拥有广泛的医疗保健背景，拥有35多年的经验与老年人合作。沙龙帮助了健康中心教育读者medication management for seniors, as well as how to prevent and care for pressure sores, so we asked her to provide insight into how home care and in-home care work. Here are Sharon’s tips.

The terms home care and in-home care are used to describe different types of services provided in the home. Additionally, state regulation and licensing entities follow certain definitions for care provided in the home and these definitions can vary from state to state. Federal programs like Medicare have their own specific definitions, and insurance companies that provide coverage for in-home care will also have their own definitions as related to what they will cover and what they will not.

It’s important to ask questions so that you are well informed, especially in regard to what services are covered at all, and for what percent or dollar amount of covered services you will be responsible. Consumers also need to explore unique options that may be available to them, including special programs for the poor and for veterans. Some programs have age restrictions while others do not.

大多数非医疗，托管家庭护理服务需要支付口袋。不幸的是，这是每天，动手护理是大多数护理人员正在寻找的关怀类型，所以发现这个护理没有覆盖可能是一个打击。大多数阿尔茨海默的护理将属于此类别，这解释了原因阿尔茨海默氏症和痴呆的护理人员可以花费这么多的口袋。一些长期护理政策将涵盖规定的小时数，但传统保险很少。

Support for activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are rarely covered by insurance. ADLs include bathing, dressing, grooming, toileting, and assistance with movement, such as walking and transferring from one surface to another, like bed-to-chair or wheelchair-to-toilet. IADLs include managing medications, shopping, laundry, housekeeping, meal preparation, and transportation.

当有人在谈论ADL和IADL时，您可能会听到使用的“监护人护理”或“非医疗保健”。您不需要来自许可的前方的医疗订单，为自己或您的朋友或亲人雇用这些服务。这些服务也可称为家庭护理，家庭护理，私人税，私人工资或非医疗，而非医疗服务，这是指由提供者订购的医疗服务。

一些家庭护理服务定义为熟练或医疗。这些服务通常被称为home health services。熟练或家庭健康服务通常需要从许可的处方的特定服务订单，例如医生或护士从业者。熟练的服务往往是短期，剧集和康复性质。事实上，这是用于Medicare家庭健康服务的定义，该定义还要求个人受到家庭限制。

技术服务提供licensed在订购的服务类型中受过教育和经验的专业人士。这种类型的护理将包括注射;输注，先进的伤口护理;ostomy care;药物管理;和售前的物理，职业或语音治疗方案。可以包括一些限量的处方者订购的家庭健康服务，但如果熟练的服务超出了康复性，客户可能需要支付口袋。

Home care companies can provide a wide variety of services. Some specialize in skilled home health, others in non-skilled/private duty/private pay, and still others may have the capacity to do it all. It is important for consumers to inquire and make the choice that best meets their needs. I want to emphasize that you want to make certain that you are clear on what services are covered by insurance and what are not, because if you aren’t, you could be in for an unexpectedly large bill.

许多家庭护理公司在他们运营的国家寻求许可证。这可能是或可能不需要，并且取决于他们正在执行的服务。例如，大多数州都需要熟练服务的许可，所有国家都需要由Medicare涵盖/报销的服务许可。一些家庭护理公司从外部第三方寻求认证，作为验证其质量护理的索赔的手段。

认可的家庭护理提供者必须符合low specific guidelines, for example adherence to national patient safety goals, like fall prevention and medication safety, that non-accredited home care companies are not. Consumers should also be mindful of how care providers are trained. Are they competency-tested? If so, by whom are they supervised and at what frequency are they tested? This can vary widely, especially in unlicensed private-duty/private-pay home care agencies.

Home care and in-home care are valuable assets, but consumers need to educate themselves on the variables as well as the quality of the company providing care.彻底采访公司so you know who you are hiring and what this care will cost you. Older adults and caregivers too frequently hire help thinking that what they need help with is covered by Medicare only to see after-the-fact that it’s not. Take advantage of these services, but first do your research so you know the score.